Multiple Choice Questions

What is the preferred method for assessing heart rate during chest compressions?
  • 23ºC to 25ºC (74° F - 77° F)
  • Decreased need for blood transfusions
  • Rapid push, as quickly as possible
  • Electronic cardiac (ECG) monitoring
You are in the delivery room caring for a preterm newborn at 27 weeks' gestation. Resuscitation has been completed and the baby is ready to be transported to the neonatal intensive care unit. Which of the following is a true statement about the baby's subsequent care?
  • Stop chest compressions; continue positive-pressure ventilation.
  • The option of providing comfort care can be considered.
  • Monitor blood glucose levels because of the risk of hypoglycemia after birth.
  • Administer CPAP at 5 cm H20 pressure
When coordinating positive-pressure ventilation with chest compressions, how many events are performed each minute?
  • 23ºC to 25ºC (74° F - 77° F)
  • 30 breaths, 90 compressions
  • Decreased need for blood transfusions
  • Rapid push, as quickly as possible
You are in the delivery room caring for a preterm newborn at 27 weeks' gestation. The baby is 5 minutes old and breathing spontaneously. The baby's heart rate is 120 beats per minute and the oxygen saturation is 90% in room air. The baby's respirations are labored. Which of the following is an appropriate action?
  • Electronic cardiac (ECG) monitoring
  • Monitor blood glucose levels because of the risk of hypoglycemia after birth.
  • Administer CPAP at 5 cm H20 pressure
  • Endotracheal tube inserted too deep
What time frame should be used to administer intravenous epinephrine?
  • Rapid push, as quickly as possible
  • Electronic cardiac (ECG) monitoring
  • Decreased need for blood transfusions
  • 30 breaths, 90 compressions
After chest compressions with coordinated ventilations are started, the heart rate should be assessed:
  • After 60 seconds
  • 23ºC to 25ºC (74° F - 77° F)
  • 30 breaths, 90 compressions
  • Decreased need for blood transfusions
During resuscitation, a baby is responding to positive-pressure ventilation with a rapidly increasing heart rate. Her heart rate and oxygen saturation suddenly worsen.She has decreased breath sounds on the left side and transillumination also reveals a bright glow on the left side.What is the most likely cause of this distress?
  • Respirations, heart rate, oxygen saturation
  • Endotracheal tube inserted too deep
  • Administer CPAP at 5 cm H20 pressure
  • Left-sided pneumothorax
Which of the following is the best indication for volume expansion after resuscitative efforts that included intubation, chest compressions, and IV epinephrine?
  • The approach to decisions in the newborn should be guided by the same principles used for adults and older children.
  • Prepare the preheated radiant warmer with a thermal mattress, plastic wrap or bag, and a hat.
  • They have more difficulty achieving effective spontaneous ventilation than term newborns
  • The baby's heart rate remains 50 beats per minute after resuscitative efforts and pulses are weak.
Which of the following is true about the preparation and resources needed for a very preterm birth?
  • Decreased need for blood transfusions
  • The baby's heart rate remains 50 beats per minute after resuscitative efforts and pulses are weak.
  • Prepare the preheated radiant warmer with a thermal mattress, plastic wrap or bag, and a hat.
  • They have more difficulty achieving effective spontaneous ventilation than term newborns
What is the appropriate dose of 1:10,000 (0.1 mg/mL) concentration of epinephrine for endotracheal administration to a baby weighing 3 kg?
  • 0.1 mL
  • Electronic cardiac (ECG) monitoring
  • 1 minute
  • 1.5 mL
Which of the following may be associated with delayed cord clamping in vigorous preterm newborns?
  • They have more difficulty achieving effective spontaneous ventilation than term newborns
  • Prepare the preheated radiant warmer with a thermal mattress, plastic wrap or bag, and a hat.
  • Decreased need for blood transfusions
  • Electronic cardiac (ECG) monitoring
A baby required ventilation and chest compressions. After 60 seconds of chest compressions, the electronic cardiac monitor indicates a heart rate of 70 beats per minute. What is your next action?
  • Respirations, heart rate, oxygen saturation
  • Endotracheal tube inserted too deep
  • The option of providing comfort care can be considered.
  • Stop chest compressions; continue positive-pressure ventilation.
A baby's heart rate does not increase after intubation and the breath sounds are louder on the right side than the left side of the chest. Which of the following is a common cause of asymmetric breath sounds in an intubated baby?
  • Stop chest compressions; continue positive-pressure ventilation.
  • Electronic cardiac (ECG) monitoring
  • Respirations, heart rate, oxygen saturation
  • Endotracheal tube inserted too deep
If a preterm birth is anticipated, at what temperature should the room be set?
  • Rapid push, as quickly as possible
  • 23ºC to 25ºC (74° F - 77° F)
  • 30 breaths, 90 compressions
  • Electronic cardiac (ECG) monitoring
In most cases, who is (are) the usual and appropriate surrogate decision maker(s) for a newborn?
  • Promptly evaluate her for possible therapeutic hypothermia (cooling) treatment and contact the nearest cooling center.
  • His blood glucose level should be checked soon after resuscitation and then at regular intervals until stable and normal.
  • Start positive-pressure ventilation
  • The newborn's parents
A laboring woman received a narcotic medication for pain relief 1 hour before delivery.The baby does not have spontaneous respirations and does not improve with stimulation.Your first priority is to
  • The newborn's parents
  • Start positive-pressure ventilation
  • Promptly evaluate her for possible therapeutic hypothermia (cooling) treatment and contact the nearest cooling center.
  • His blood glucose level should be checked soon after resuscitation and then at regular intervals until stable and normal.
When a newborn has a high risk of mortality and there is a significant burden of morbidity among survivors, what should be included in your discussion with the parents concerning options for resuscitation?
  • Stop chest compressions; continue positive-pressure ventilation.
  • The option of providing comfort care can be considered.
  • Respirations, heart rate, oxygen saturation
  • The baby's heart rate remains 50 beats per minute after resuscitative efforts and pulses are weak.
A mother had an emergency cesarean birth at 39 weeks' gestational because of sudden fetal bradycardia and a suspected placental abruption. After birth, the baby required extensive resuscitation including positive pressure ventilation, intubation, chest compressions and intravenous epinephrine. Afterward, the baby has poor tone, lethargy, and apnea. Which of the following statements is true?
  • Promptly evaluate her for possible therapeutic hypothermia (cooling) treatment and contact the nearest cooling center.
  • Start positive-pressure ventilation
  • His blood glucose level should be checked soon after resuscitation and then at regular intervals until stable and normal.
  • The newborn's parents
For a newborn weighing 1 kg, what dose of 1:10,000 (0.1 mg/mL) concentration of intravenous epinephrine is indicated?
  • 1.5 mL
  • 10 minutes
  • 0.1 mL
  • 1 minute
After what duration of time might it be reasonable to consider discontinuing resuscitation following complete resuscitation efforts with no detectable heart rate?
  • 1 minute
  • 1.5 mL
  • 10 minutes
  • After 60 seconds
When are chest compressions indicated?
  • They have more difficulty achieving effective spontaneous ventilation than term newborns
  • When the heart rate remains less than 60 beats per minute after 30 seconds of positive-pressure ventilation that moves the chest, preferably through an alternative airway.
  • Prepare the preheated radiant warmer with a thermal mattress, plastic wrap or bag, and a hat.
  • The baby's heart rate remains 50 beats per minute after resuscitative efforts and pulses are weak.
Which statement best describes the ethical principle(s) that guide the resuscitation of a newborn?
  • The baby's heart rate remains 50 beats per minute after resuscitative efforts and pulses are weak.
  • The approach to decisions in the newborn should be guided by the same principles used for adults and older children.
  • They have more difficulty achieving effective spontaneous ventilation than term newborns
  • Prepare the preheated radiant warmer with a thermal mattress, plastic wrap or bag, and a hat.
A woman is admitted at 24 weeks' gestation with rupture of membranes, maternal fever, and premature labor.The care team offers the parents counseling.What is likely to be helpful?
  • The newborn's parents
  • Start positive-pressure ventilation
  • His blood glucose level should be checked soon after resuscitation and then at regular intervals until stable and normal.
  • Provide parents with accurate prognostic information using all relevant information affecting their baby's prognosis.
What is the target axillary temperature range for the preterm newborn?
  • After 60 seconds
  • 36.5ºC to 37.5ºC
  • Electronic cardiac (ECG) monitoring
  • 1.5 mL
Which of the following statements is true about resuscitating and stabilizing extremely premature newborns?
  • They have more difficulty achieving effective spontaneous ventilation than term newborns
  • The baby's heart rate remains 50 beats per minute after resuscitative efforts and pulses are weak.
  • Prepare the preheated radiant warmer with a thermal mattress, plastic wrap or bag, and a hat.
  • Decreased need for blood transfusions
How soon after administration of intravenous epinephrine should you pause compressions and reassess the baby's heart rate?
  • 1.5 mL
  • 1 minute
  • 0.1 mL
  • 10 minutes
A 10-day-old, mechanically ventilated newborn suddenly develops bradycardia and low oxygen saturation, despite the oxygen concentration being increased to 100%. What is the first and the most important step in the resuscitation of this newborn?
  • Assess and establish adequate ventilation.
  • Endotracheal tube inserted too deep
  • Administer CPAP at 5 cm H20 pressure
  • Respirations, heart rate, oxygen saturation
You are counseling a set of 17-year-old parents,whose baby is about to be born at 23 weeks' gestation. You have explained the chance of survival is low and that if the baby survives there is a high likelihood of long-term morbidity.The parents understand your discussion and clearly request that you provide life-sustaining treatment in the delivery room.How might you answer them?
  • Adjusting the oxygen concentration to maintain oxygen saturations in the 85% to 95% range at 10 minutes after birth.
  • Monitor blood glucose levels because of the risk of hypoglycemia after birth.
  • Administer CPAP at 5 cm H20 pressure
  • You assure them that, as the parents, they are the appropriate decision makers for their baby and you will support their decision.
Premature newborns are vulnerable to hyperoxia.Which action is appropriate with a pulse oximeter and blender during and immediately following resuscitation of preterm babies?
  • The baby's heart rate remains 50 beats per minute after resuscitative efforts and pulses are weak.
  • You assure them that, as the parents, they are the appropriate decision makers for their baby and you will support their decision.
  • The option of providing comfort care can be considered.
  • Adjusting the oxygen concentration to maintain oxygen saturations in the 85% to 95% range at 10 minutes after birth.
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Multiple Choice Questions
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